US8647575B2 - Device for measuring blood component - Google Patents

Device for measuring blood component Download PDF

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Publication number
US8647575B2
US8647575B2 US13/129,945 US200913129945A US8647575B2 US 8647575 B2 US8647575 B2 US 8647575B2 US 200913129945 A US200913129945 A US 200913129945A US 8647575 B2 US8647575 B2 US 8647575B2
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Prior art keywords
test piece
distal end
blood
measuring apparatus
blood component
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US13/129,945
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US20110223078A1 (en
Inventor
Hirotaka Ohashi
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Terumo Corp
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Terumo Corp
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Priority claimed from JP2008297869A external-priority patent/JP5320038B2/ja
Priority claimed from JP2009050494A external-priority patent/JP5320111B2/ja
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
    • A61B5/1455—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue using optical sensors, e.g. spectral photometrical oximeters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
    • A61B5/14532—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue for measuring glucose, e.g. by tissue impedance measurement
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
    • A61B5/14546—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue for measuring analytes not otherwise provided for, e.g. ions, cytochromes
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
    • G01N21/00—Investigating or analysing materials by the use of optical means, i.e. using sub-millimetre waves, infrared, visible or ultraviolet light
    • G01N21/75—Systems in which material is subjected to a chemical reaction, the progress or the result of the reaction being investigated
    • G01N21/77—Systems in which material is subjected to a chemical reaction, the progress or the result of the reaction being investigated by observing the effect on a chemical indicator
    • G01N21/78—Systems in which material is subjected to a chemical reaction, the progress or the result of the reaction being investigated by observing the effect on a chemical indicator producing a change of colour
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
    • G01N21/00—Investigating or analysing materials by the use of optical means, i.e. using sub-millimetre waves, infrared, visible or ultraviolet light
    • G01N21/84—Systems specially adapted for particular applications
    • G01N21/8483—Investigating reagent band
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
    • G01N33/00—Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
    • G01N33/48—Biological material, e.g. blood, urine; Haemocytometers
    • G01N33/483—Physical analysis of biological material
    • G01N33/487—Physical analysis of biological material of liquid biological material
    • G01N33/48785—Electrical and electronic details of measuring devices for physical analysis of liquid biological material not specific to a particular test method, e.g. user interface or power supply
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2562/00—Details of sensors; Constructional details of sensor housings or probes; Accessories for sensors
    • A61B2562/02—Details of sensors specially adapted for in-vivo measurements
    • A61B2562/0295—Strip shaped analyte sensors for apparatus classified in A61B5/145 or A61B5/157
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2562/00—Details of sensors; Constructional details of sensor housings or probes; Accessories for sensors
    • A61B2562/08—Sensors provided with means for identification, e.g. barcodes or memory chips
    • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10T—TECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION
    • Y10T436/00—Chemistry: analytical and immunological testing
    • Y10T436/11—Automated chemical analysis
    • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10T—TECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION
    • Y10T436/00—Chemistry: analytical and immunological testing
    • Y10T436/25—Chemistry: analytical and immunological testing including sample preparation
    • Y10T436/25375—Liberation or purification of sample or separation of material from a sample [e.g., filtering, centrifuging, etc.]

Definitions

  • This invention relates to a blood component measuring apparatus (device) for measuring a component such as glucose from blood sampled through a blood introduction path in a test piece, which is mounted on a distal end mounting portion of the blood component measuring apparatus.
  • a blood glucose meter has been placed into practical use, in which a measurement portion, such as a test paper impregnated with a reagent that develops a color in response to the amount of glucose in blood, is provided. Blood is applied to the test paper so that the test paper develops a color, and the degree of the color is measured optically and calculated in order to display the blood glucose level (for example, refer to Japanese Utility Model Registration No. 3135393 (FIGS. 2 and 8), Japanese Laid-Open Patent Publication No. 2000-046834, and U.S. Pat. No. 7,077,328).
  • the test paper is provided on a disposable test piece, and the test piece is mounted on a distal end mounting portion of the blood glucose meter. Further, a blood glucose meter in which an electric chemical sensor is used has also been placed into practical use.
  • the skin for example, a finger, a palm, or the like
  • blood is debouched by a small amount after the puncture.
  • a test piece is mounted on the blood glucose meter and a spotted portion at the distal end of the test piece is brought into contact with a blood drop, whereby the blood is introduced to the test paper by capillary action through a communication path having a very small diameter.
  • blood glucose meters in recent years are demanded not only for personal use, in which a diabetic uses the blood glucose meter to measure the blood glucose levels daily, but also for hospital use, in which a health care worker carries out measurement with regard to plural patients who are hospitalized in medical facilities.
  • the blood drop 900 is directed substantially upward, then the blood glucose meter 901 approaches the blood drop 900 from an upward or obliquely upward location. Therefore, the blood drop 900 or the spotted portion 903 of the test piece 902 is placed in a blind spot by the blood glucose meter 901 and the right hand.
  • Such a situation impairs visibility and sometimes makes it less easy to carry out the spotting operation. Since the spotted portion of the test piece is an operation carried out upon measurement of blood glucose levels, good visibility upon operation is demanded. Also, even when the blood glucose meter is placed on a table, visibility still is demanded to enable confirmation of the state of operation.
  • test piece that is mounted on the blood glucose meter when the blood glucose meter is placed on a table.
  • test piece when the blood glucose meter is placed on a table, it is desirable for the test piece to be spotted on the blood after the spotted portion has been positioned in advance with respect to proximity of the blood drop.
  • blood glucose meters have a function for storing measurement values of blood glucose levels carried out a plural number of times, since it is supposed that one blood glucose meter is used for measurement of blood glucose levels of multiple patients in a medical facility, there is the necessity to store measured blood glucose levels in a state in which the blood glucose levels are distinguishable for individual patients. Further, for recording and traceability, it is desirable to make it possible to specify an operator who carries out measurement of blood glucose levels at each time of measurement. In order to specify a patient and an operator in the foregoing manner, it is necessary to read identification information of the patient and the operator into the blood glucose meter.
  • a test piece which is mounted on the distal end measurement portion, may hit against some different body (including a living body) upon reading of the barcode. If such a hit occurs before measurement of the blood glucose level is taken, then there is a possibility that the spotted portion of the test piece may become soiled or broken, resulting in a measurement failure. Further, if such a hit occurs after measurement of the blood glucose level, since blood sticks onto the spotted portion, a different body with which the spotted portion comes into contact may become soiled.
  • the distal end portion since a monitor is disposed in proximity to the distal end measuring portion, the distal end portion has a considerable size, which impedes balance. Further, since a gripping portion is positioned rearwardly with respect to the monitor, the gripping portion is positioned far from the distal end measuring portion. As a result, the distal end measuring portion is likely to become unstable.
  • a first object of the present invention is to provide a blood component measuring apparatus, which allows a spotted portion of a test piece to be brought into contact readily and with certainty with a blood drop obtained by puncture, thereby to suppress errors in measurement.
  • a second object of the present invention is to provide a blood component measuring apparatus, which can carry out reading of data simply, conveniently, quickly and stably.
  • a blood component measuring apparatus on which a test piece is mounted, including a distal end mounting portion on which the test piece is capable of being mounted, a measuring portion adapted to measure components of blood sampled through a blood introduction path provided in the test piece that is mounted on the distal end mounting portion, and a monitor adapted to display a result determined by the measuring portion and a predetermined control section, wherein a display face of the monitor is defined as an upper side, while an opposite face to the display face is defined as a lower side, and wherein, when the blood component measuring apparatus is placed on a horizontal plane in a state in which the display face of the monitor is directed upwardly, a center axial line of the test piece is directed obliquely downward toward the distal end side.
  • the blood component measuring apparatus By shaping the blood component measuring apparatus in this manner, such that, when the blood component measuring apparatus is placed on a horizontal plane, the center axial line of the test piece is directed obliquely downward toward the distal end side, it becomes easy to orient the spotted portion of the test piece in a direction toward the blood drop. Consequently, the spotted portion of the test piece can be brought into contact readily and reliably with a blood drop obtained by puncture, whereby measurement errors can be suppressed.
  • a blood component measuring apparatus on which a test piece is mounted, including a distal end mounting portion on which the test piece is capable of being mounted, a measuring portion adapted to measure components of blood sampled through a blood introduction path provided in the test piece that is mounted on the distal end mounting portion, and a monitor adapted to display a result determined by the measuring portion and a predetermined control section, wherein a display face of the monitor is defined as an upper side, while an opposite face to the display face is defined as a lower side, and wherein a center axial line of the test piece is directed, as viewed in side elevation, obliquely downward toward the distal end side with reference to a line of extension of the display face of the monitor.
  • the blood component measuring apparatus By shaping the blood component measuring apparatus in this manner, such that the center axial line of the test piece is directed obliquely downward toward the distal end side with reference to the line of extension of the display face of the monitor, it becomes easy to direct the spotted portion of the test piece in a direction toward the blood drop. Consequently, the spotted portion of the test piece can be brought into contact readily and reliably with a blood drop obtained by puncture, whereby measurement errors can be suppressed.
  • An angle defined by the line of extension and the center axial line may be 10° to 40°. According to such an angle setting, the spotted portion of the test piece is oriented more correctly in a direction toward the blood drop.
  • the blood component measuring apparatus may further include a main portion on which the monitor is provided, and an intermediate portion provided between the main portion and the distal end mounting portion, wherein an upper face of the intermediate portion is set substantially parallel to the center axial line.
  • a space in which several mechanisms relating to the distal end mounting portion can be provided is assured in a preferred direction.
  • the intermediate portion since the intermediate portion is provided, it is easy to direct the center axial line of the test piece obliquely downward toward the distal end side.
  • by setting the upper face of the intermediate portion substantially parallel to the center axial line of the test piece it is easy to visually grasp the direction of the test piece.
  • An ejector lever for removing the mounted test piece by performing a push out operation toward the distal end side may be provided on the upper face of the intermediate portion.
  • the intermediate portion may have a width that decreases continuously and concavely from the main portion toward the distal end side.
  • the intermediate portion is made suitably thin and further has a concave shape. Consequently, the intermediate portion can be grasped readily by the fingers. Further, since the intermediate portion is positioned near to the distal end mounting portion, by grasping the intermediate portion, the test piece that is mounted thereon can be stabilized.
  • a thickness of the main portion in a vertical direction may be substantially fixed, and as viewed in side elevation, the main portion and the intermediate portion may be connected to each other by a continuously curved face portion, the lower face of which has a concave shape. It is easy to place a finger on such a concave and continuous curved face, and thus it is easy to grasp the blood component measuring apparatus.
  • the blood component measuring apparatus may be configured such that, when the test piece is mounted on the distal end mounting portion and the blood component measuring apparatus is placed on the horizontal plane, in a state in which the display face of the monitor is directed upwardly, a distance between a spotted portion at the distal end of the test piece and the horizontal plane is 3 mm to 30 mm.
  • a distance between a spotted portion at the distal end of the test piece and the horizontal plane is 3 mm to 30 mm.
  • the distance between a highest point of the lower face and the horizontal plane may be 3 mm to 20 mm.
  • test piece When the test piece is mounted on the distal end mounting portion and the blood component measuring apparatus is placed on the horizontal plane in a state in which the display face of the monitor is directed upwardly, the test piece may be spaced away from the horizontal plane. By this configuration, unnecessary external forces are prevented from being applied to the test piece.
  • the blood component measuring apparatus is shaped such that, when the blood component measuring apparatus is placed on a horizontal plane, the center axial line of the test piece is directed obliquely downward toward the distal end side.
  • the blood component measuring apparatus is shaped such that the center axial line is directed obliquely downward toward the distal end side, with reference to a line of extension of the display face of the monitor.
  • a blood component measuring apparatus on which a test piece is mounted, including a distal end mounting portion on which a test piece is capable of being mounted, a measuring portion adapted to measure components of blood sampled through a blood introduction path provided in the test piece that is mounted on the distal end mounting portion, and a monitor adapted to display a result determined by the measuring portion and a predetermined control section, optical data reading means provided at a rear end, a main portion on which the monitor is provided, an intermediate portion provided between the main portion and the distal end mounting portion, and a curved face portion, which serves as a connection portion between the main portion and the intermediate portion, and the lower face of which has a concave shape as viewed in side elevation.
  • the optical data reading means is provided at the rear end portion, the optical data reading means is spaced away from the distal end mounting portion and is directed in an opposite direction. Consequently, upon reading of data, the test piece can be prevented from hitting against a different body. Further, the concave curved face portion can be used as a grasping portion, and the concave curved face is positioned near the distal end mounting portion. Therefore, it is easy to adjust the location of the spotted portion of the test piece with respect to the blood drop, and thus a stabilized operation can be achieved. In this manner, with the blood component measuring apparatus according to the present invention, reading of data can be carried out simply, conveniently, quickly and stably.
  • An operation switch for the optical data reading means may be provided on a face on which the monitor is disposed between the monitor and the distal end mounting section.
  • the location between the monitor and the distal end mounting portion is a position at which it is easy to operate the operation switch, and thus it is preferable to provide the operation switch at such a position. Further, since the operation switch is located at this position, there is no need to change the grasping position of the hand upon measurement of the blood component and upon reading of data, which is efficient.
  • the operation switch is positioned substantially on an opposite side to the curved face portion, and is held by and between a finger (for example, the forefinger), which is placed on the curved face portion, and another finger (for example, the thumb) that presses the operation switch, thereby permitting stabilized grasping and operation.
  • the optical data reading means may comprise a barcode reader.
  • the optical data reading means may comprise a camera for reading a two-dimensional code.
  • the intermediate portion may have a width that decreases continuously and concavely from the main portion toward the distal end side.
  • the intermediate portion is made suitably thin and has a concave shape. Consequently, the intermediate portion can be grasped readily by the fingers. Further, since the intermediate portion is positioned near to the distal end mounting portion, by grasping the intermediate portion, it is easy to bring the blood drop into contact with the spotted portion of the mounted test piece, so that a stabilized operation can be carried out.
  • the finger can be placed more readily on the curved face portion.
  • a display face of the monitor may be defined as an upper side, while an opposite face to the display face may be defined as a lower side.
  • a center axial line of the test piece may be directed obliquely downward toward the distal end side with reference to a line of extension of the display face of the monitor.
  • the optical data reading means is provided at the rear end portion, the optical data reading means is oriented in a direction opposite to the test piece and the measuring portion at the distal end, and in a direction opposite from the patient. Consequently, the optical data reading means does not cause the patient to experience any discomfort.
  • the curved face portion the lower face of which is concave, is provided at the connecting portion between the main portion and the intermediate portion, a finger can be placed thereon to stabilize the blood component measuring apparatus. Accordingly, optical reading by the optical data reading means can be carried out in a stable manner.
  • FIG. 1 is a perspective view of a blood glucose meter according to a present embodiment
  • FIG. 2 is a plan view of the blood glucose meter according to the present embodiment
  • FIG. 3 is a side elevational view of the blood glucose meter according to the present embodiment
  • FIG. 4 is an enlarged perspective view of a rear end portion of the blood glucose meter according to the present embodiment
  • FIG. 5 is a cross sectional view of a test piece
  • FIG. 6 is a side elevational view of the blood glucose meter in a state of being grasped with a finger placed on a curved face portion;
  • FIG. 7 is a schematic view of the blood glucose meter in a state in which an intermediate portion thereof is grasped
  • FIG. 8 is a view illustrating a manner in which a health care worker reads measuring person identification data using the blood glucose meter
  • FIG. 9 is a view illustrating a manner in which a health care worker reads patient identification data using the blood glucose meter
  • FIG. 10 is a schematic view at a preceding stage before a spotting operation is carried out with the wrists or neighboring portions of the left and right hands being placed on a table, and while the blood glucose meter is grasped;
  • FIG. 11 is a schematic view showing a state in which a spotting operation is carried out with the wrists or neighboring portions of the left and right hands being placed on a table, and while the blood glucose meter is grasped;
  • FIG. 12 is a schematic view showing a state in which one finger is placed on a table, and a spotting operation is carried out by the blood glucose meter, which is placed on the table;
  • FIG. 13 is a schematic view showing a state in which two fingers are placed on a table, and a spotting operation is carried out by the blood glucose meter, which is placed on the table;
  • FIG. 14 is a schematic view showing a state in which a health care worker carries out a spotting operation on a patient
  • FIG. 15 is a schematic view showing a state in which a health care worker carries out a spotting operation on a patient
  • FIG. 16 is a perspective view of a blood glucose meter according to a first modification
  • FIG. 17 is a perspective view of a test piece applied to the blood glucose meter according to the first modification
  • FIG. 18 is a plan view of a blood glucose meter according to a second modification
  • FIG. 19 is a side elevational view of the blood glucose meter according to the second modification.
  • FIG. 20 is a perspective view of a blood glucose meter according to a third modification
  • FIG. 21 is a schematic view of a first example in which a spotting operation is carried out by a blood glucose meter according to the conventional art.
  • FIG. 22 is a schematic view of a second example in which a spotting operation is carried out by a blood glucose meter according to the conventional art.
  • FIGS. 1 to 20 of the accompanying drawings An embodiment of a blood component measuring instrument according to the present invention will be described with reference to FIGS. 1 to 20 of the accompanying drawings.
  • the blood glucose meter (blood component measuring instrument) 10 a includes a distal end on which a test piece 12 is mounted.
  • the blood glucose meter 10 a has a function of storing values obtained by blood glucose measurements carried out a plural number of times.
  • the single blood glucose meter 10 a can be used for blood glucose measurements of a plurality of patients.
  • the test piece 12 shall be described.
  • the test piece 12 includes a base tube 14 , a flange 16 that covers one end of the base tube 14 , a conical projection 18 projecting from the flange 16 , and a test paper 20 , which is stuck to the rear face of the flange 16 .
  • a plurality of slits 14 a are provided in the base tube 14 .
  • a linear blood introduction path 24 which extends from a spotted portion 22 at the end of the projection 18 and which communicates with the test paper 20 , is provided at the center of the projection 18 .
  • materials for the test paper 20 for example, polyether sulfone can be used.
  • a chromogenic agent such as, for example, glucose oxidase (GOD), peroxidase (POD), 4-aminoantipyrine or N-ethyl-N(2-hydroxy-3-sulfopropyl) can be used.
  • the reagent may contain a predetermined buffering agent.
  • the blood introduction path 24 generally is provided on a center axial line C of the test piece 12 .
  • the center axial line C of the test piece 12 forms a straight line that extends in a direction in which the spotted portion 22 of the test piece 12 is directed, the straight line passing through the distal end of the spotted portion 22 .
  • the test piece 12 is a so-called disposable article, and is packaged in an individual package body (not shown) and sterilized in advance.
  • the blood introduction path 24 is set sufficiently small in diameter, to such a degree that the blood introduction path 24 is capable of sucking blood by capillary action, and of introducing the blood, which is brought into contact with the spotted portion 22 , to the test paper 20 .
  • a conventional article can be applied as is to the test piece 12 .
  • the blood glucose meter 10 a includes a distal end mounting portion 30 on which the test piece 12 is mounted, a measuring portion 32 for measuring a developed color of the test paper 20 caused by a blood component that is sampled through the blood introduction path 24 of the test piece 12 , which is mounted on the distal end mounting portion 30 , a liquid crystal monitor 34 for displaying a result of measurement by the measuring portion 32 through a control section (microcomputer, etc.) 33 , an ejector lever 36 for removing the mounted test piece 12 by carrying out a push out operation toward the distal end side, an operation button group 38 , a data reading button 40 , and a cap 39 for protecting the distal end mounting portion 30 .
  • the blood glucose meter 10 a has a smooth shape, which generally is free of angled portions. In order to avoid complexity in illustration, the cap 39 has been omitted from the figures, except FIG. 1 .
  • various mechanisms can be adopted in accordance with the component detection method of the test piece 12 .
  • the blood glucose meter 10 a is for hospital use, wherein a hospital care worker uses the blood glucose meter 10 a to carry out measurements with regard to plural patients who are hospitalized in a hospital facility.
  • the blood glucose meter 10 a includes data recording and calling functions for each patient along with buttons for such functions.
  • the blood glucose meter 10 a has a size that is somewhat greater than that of a blood glucose meter 10 c for personal use (refer to FIG. 18 ), which shall be described later.
  • the blood glucose meter 10 a can also be used as is, as an apparatus for personal use, without applying special remodeling to the blood glucose meter 10 a.
  • the distal end mounting portion 30 has a cylindrical shape to facilitate mounting of the test piece 12 .
  • the test piece 12 can be mounted readily and stably on the distal end mounting portion 30 by insertion of the base tube 14 (refer to FIG. 5 ).
  • the blood glucose meter 10 a is controlled by the internal control section 33 to continuously carry out projection of light to and reception of light from the test paper 20 by means of the measuring portion 32 , which is configured from an optical means. Further, the blood glucose meter 10 a calculates a blood glucose level by performing a predetermined calculation based on a color reaction of light, and displays the blood glucose level on the monitor 34 . If a color reaction of the test paper 20 cannot be observed or is otherwise insufficient, then a predetermined error is displayed.
  • the control procedure for blood glucose level measurement by the blood glucose meter 10 a basically is the same as that of a conventional blood glucose meter according to the conventional art.
  • the monitor 34 includes a blood glucose level display portion 34 a for displaying a blood glucose level, and an auxiliary display portion 34 b for displaying time and other information.
  • the blood glucose level display portion 34 a can display a three digit numerical value and a predetermined character display (for example, characters such as “OK”). Since some diabetics have weak sight, the monitor 34 is set sufficiently large taking visibility into consideration.
  • a predetermined character display for example, characters such as “OK”. Since some diabetics have weak sight, the monitor 34 is set sufficiently large taking visibility into consideration.
  • On the auxiliary display portion 34 b patient identification data, operator identification data, and test piece identification data read by a later described barcode reader 48 also are displayed.
  • the monitor 34 is flat on at least the liquid crystal display face portion thereof.
  • the operation button group 38 is provided collectively on the proximal end side, and includes a power supply button 38 a , movement buttons 38 b and 38 c , selection buttons 38 d and 38 e , and an LED display portion 38 f .
  • the movement buttons 38 b and 38 c function to move an item displayed on the monitor 34 , or to scroll the screen image together with movement of the displayed item, etc.
  • the selection buttons 38 d and 38 e operate to select a function, which is displayed on the monitor 34 , corresponding to the position thereof.
  • the LED display portion 38 f functions to notify a state of the blood glucose meter by means of an LED, which emits light or blinks in various colors.
  • the ejector lever 36 is a round-shaped lever, which is provided on an upper face 46 a in proximity to the distal end mounting portion 30 .
  • the ejector lever 36 can suitably be grasped by a finger, and includes a flat portion 36 a on the proximal end side and a projecting portion 36 b on the distal end side thereof.
  • the ejector lever 36 is movable along the upper face 46 a .
  • a plurality of ribs, which extend in a lateral direction, are provided on the flat portion 36 a for preventing slippage.
  • the projecting portion 36 b has a width and height suitable for being grasped by a finger.
  • the ejector lever 36 is elastically biased toward the proximal end side by means of a suitably weak resilient member. If the ejector lever 36 is grasped by the finger in order to carry out a push out operation toward the distal end side, then the ejector lever 36 moves in parallel to an axial direction of the cylindrically shaped distal end mounting portion 30 . Thereupon, the ejector mechanism inside the ejector lever 36 moves in an interlocking relation, so as to push out the test piece 12 and enable removal of the test piece 12 from the distal end mounting portion 30 . Further, with the aforementioned configuration, wiping and cleaning in the vicinity of the ejector lever 36 can easily be carried out.
  • the data reading button 40 is an operation switch for a barcode reader (optical data reading means) 48 provided at a rear end portion.
  • the data reading button 40 can be easily operated if the data reading button 40 is disposed between the monitor 34 and the distal end mounting portion 30 on a face (hereinafter referred to as a monitor face) on which the monitor 34 is provided. Further, since the data reading button 40 is provided at this position, it is unnecessary to change the grasping position of the hand when measurement of a blood component and reading of data are carried out, which is efficient.
  • a plurality of data reading buttons 40 may be provided at neighboring positions in accordance with applications to be performed thereby (for example, for reading patient identification data, measuring person identification data, and test piece identification data). Further, different processes can be executed in response to operation methods (depending upon a difference in a switch-on time, or a difference in the number of times that switching is performed within a predetermined short time period).
  • a barcode reader 48 is provided at a concave portion 49 on a rear end portion of the blood glucose meter 10 a .
  • the barcode reader 48 serves as a means for reading a barcode in order to obtain patient identification data, measuring person identification data, and test piece identification data by means of laser scanning.
  • the barcode reader 48 is of a conventional laser type and is inexpensive.
  • a rear end portion of the blood glucose meter 10 a is inclined so as to expand toward the monitor screen as viewed in side elevation (refer to FIG. 3 ). Since the barcode reader 48 is provided at the aforementioned inclined rear end portion within the concave portion 49 , the barcode reader 48 cannot be touched inadvertently, and thus the measurement face is less likely to become soiled.
  • the blood glucose meter 10 a has a function for storing blood glucose measurement values, which are measured a plural number of times, and can store blood glucose measurement values distinctively for individual patients, based on patient identification data read by the barcode reader 48 . Further, for so-called traceability, an operator who carries out blood glucose measurements can be specified for each measurement, based on measuring person identification data read by the barcode reader 48 . Further, based on identification data for specifying the type of test piece 12 , it can be confirmed that an appropriate test piece 12 has been used. Information read by the barcode reader 48 is identified by an operation method of the data reading button 40 , and such information is displayed distinctively on the monitor 34 . After the patient identification data, the measuring person identification data, and the test piece identification data have been read by the barcode reader 48 , a predetermined measurement mode is entered. Consequently, measurements can be started in accordance with the correct procedure.
  • the barcode reader 48 Since the barcode reader 48 is disposed at the rear end portion, the barcode reader 48 is oriented in an opposite direction along the direction of the arrow A toward the test piece 12 , and since the measuring portion 32 is disposed at the distal end in an opposite direction to the patient, it is less likely for the patient to experience discomfort. Further, since the barcode reader 48 is provided in an opposite direction, operations for measurement of blood glucose and reading of data can easily be distinguished from each other.
  • an intermediate portion 46 can be formed suitably thin.
  • An auxiliary function button which has a function unique for hospital use, may be provided in place of the data reading button 40 .
  • the display face of the monitor 34 is defined as an upper side, whereas the opposite side is defined as a lower side.
  • orientation of the blood glucose meter 10 a during use, during storage and so forth is not limited to such definitions.
  • the housing of the blood glucose meter 10 a is principally configured from an upper housing 42 a , on which the monitor 34 and the operation button group 38 are provided, and a lower housing 42 b , which is joined to the upper housing 42 a and makes up a lower side portion.
  • an upper housing 42 a on which the monitor 34 and the operation button group 38 are provided
  • a lower housing 42 b which is joined to the upper housing 42 a and makes up a lower side portion.
  • the blood glucose meter 10 a can be segmented, as viewed from above (refer to FIG. 2 ), into a main portion 44 on which the monitor 34 and the operation button group 38 are provided, and an intermediate portion 46 , which is provided between the main portion 44 and the distal end mounting portion 30 .
  • the intermediate portion 46 is configured to have a width that decreases from the main portion 44 continuously and concavely toward the distal end side.
  • the distal end mounting portion 30 is provided on a distal end face of the intermediate portion 46 .
  • the data reading button 40 is provided directly at a boundary between the main portion 44 and the intermediate portion 46 , so that the data reading button 40 can be touched and operated easily.
  • the main portion 44 includes the monitor 34 provided thereon and has a certain width, which enables the main portion 44 to be grasped by the hand of a user.
  • the main portion 44 has a substantially fixed width as viewed from above (refer to FIG. 2 ) in a longitudinal direction (in the direction of the arrow A shown in FIGS. 2 and 3 ), and has a substantially fixed thickness in a vertical direction as viewed in side elevation (refer to FIG. 3 ). Consequently, the main portion 44 can be grasped easily.
  • the blood glucose meter 10 a is symmetric in shape in leftward and rightward directions, and can be grasped easily by either the right hand or the left hand.
  • the blood glucose meter 10 a can be grasped not only at the main portion 44 but also at the intermediate portion 46 .
  • the intermediate portion 46 has a width that decreases continuously and concavely toward the distal end side from the main portion 44 , and since the intermediate portion 46 is suitably thin and concave, the intermediate portion 46 can be grasped easily by the fingertips. Further, since the intermediate portion 46 is positioned near to the distal end mounting portion 30 , the mounted test piece 12 can be stabilized by grasping the intermediate portion 46 .
  • a space is provided in a suitable direction, in which several mechanisms relating to the distal end mounting portion 30 (for example, the measuring portion 32 for the test paper 20 , an ejector mechanism for the test piece 12 , a mechanism for holding the distal end mounting portion 30 , and so forth) are disposed.
  • the center axial line C of the test piece 12 can easily be oriented in an obliquely downward direction toward the distal end side.
  • the upper face 46 a of the intermediate portion 46 is set substantially parallel to the center axial line C of the test piece 12 , and therefore the direction of the test piece 12 can easily be perceived visually.
  • the ejector lever 36 is provided on the upper face 46 a of the intermediate portion 46 . Since the ejector lever 36 is moved along the upper face 46 a , operation of the ejector lever 36 is facilitated and a space for movement of the ejector lever 36 can be assured.
  • the center axial line C is directed obliquely downward toward the distal end side, with reference to a line of extension L of the display face of the monitor 34 .
  • the center axial line C of the test piece 12 is directed obliquely downward toward the distal end side.
  • the angle ⁇ 1 defined between the line of extension L and the center axial line C is set at 27°
  • the angle ⁇ 2 defined between the line of extension L and the table T is set at 7°.
  • the test piece 12 which is mounted on the distal end mounting portion 30 , is spaced from the table T, such that no unnecessary external forces are applied to the test piece 12 .
  • a lower face of the main portion 44 and a lower face of the intermediate portion 46 are connected to each other by a continuous curved face portion 50 , which is concave as viewed in side elevation.
  • a finger receiving projection 52 is provided at a neighboring portion on the proximal end side, as viewed from the curved face portion 50 .
  • the finger receiving projection 52 has a low triangular shape as viewed in side elevation, and forms a smooth arc together with the curved face portion 50 , such that a space is formed into which a single finger can be inserted. If the radius of curvature of the curved face portion is 5 mm to 25 mm, and more preferably 8 mm to 20 mm, then a finger can easily be placed thereon in a suitable manner. Since, as described above, it is easy to place a finger on the curved face portion 50 , the blood glucose meter 10 a can be grasped readily.
  • the blood glucose meter 10 a can be grasped stably by placing a finger (for example, the forefinger) on the curved face portion 50 . Since the curved face portion 50 , the lower face of which is concave, is provided on the connecting portion between the main portion 44 and the intermediate portion 46 , the finger is placed on the curved face portion 50 in order to stabilize the blood glucose meter 10 a , whereby optical reading by the barcode reader 48 can be carried out stably.
  • a finger for example, the forefinger
  • the data reading button 40 is provided on a side substantially opposite to the curved face portion 50 , and is held by and between the finger (for example, the forefinger) that is placed on the curved face portion 50 and another finger (for example, the thumb), which presses the data reading button 40 , so as to allow stable grasping and operation of the data reading button 40 .
  • the finger for example, the forefinger
  • another finger for example, the thumb
  • the concave curved face portion 50 can be used as a grasping portion. Further, since the concave curved face portion 50 is positioned near the distal end mounting portion 30 , it is easy to adjust the position of the spotted portion 22 with respect to a blood drop 60 , which makes operations as stable as possible.
  • the distance H 1 between the spotted portion 22 of the blood glucose meter 10 a and the table T is 13 mm, and the distance H 2 between the highest point P of the lower face and the table T is 11 mm.
  • the highest point P forms a part of the curved face portion 50 .
  • the spotted portion 22 is an operation object portion during blood glucose measurement, good visibility when operations are performed is demanded. Also, when the blood glucose meter 10 a is placed on the table T, good visibility is required to enable state confirmation. Although it is preferable for the spotted portion 22 to be kept in a spaced relation from the table T, the spotted portion 22 should not be spaced away from the table T needlessly. Further, as hereinafter described (refer to FIGS. 12 and 13 ), if it is taken into consideration to carry out a spotting operation while the blood glucose meter 10 a is kept in place on the table T, there is a suitable range for the distance H 1 . From such a point of view, it is preferable to set the distance H 1 within a range from 3 mm to 30 mm, and more preferably, within a range from 9 mm to 14 mm.
  • the distance H 2 is set within a range from 3 mm to 20 mm, and more preferably, within a range from 7 mm to 12 mm.
  • a power supply to the blood glucose meter 10 a is made available, and a predetermined barcode, which is indicated on an individualized package for the test piece 12 , is read by the barcode reader 48 .
  • a health care worker 62 directs the barcode reader 48 toward a card, on which a barcode 62 b representative of operator identification data of the health care worker 62 is provided, and depresses the data reading button 40 in order to read the operator identification data.
  • the data is recorded together with a blood glucose measurement value. Such data is used, for example, for confirmation of traceability of the procedure.
  • the barcode reader 48 since the barcode reader 48 is directed toward the health care worker 62 , the laser beam does not hit upon a patient 64 and the patient 64 does not experience any discomfort.
  • the barcode reader 48 is provided on an opposite side to the test piece 12 , and the data reading button 40 is provided at a position where the button can be operated readily by the thumb or the like, there is no need to change the grasping position of the hand when measurement of a blood component and reading of data are performed, which is efficient.
  • patient identification data of the patient 64 which is indicated on a wrist band 64 a , is read by the barcode reader 48 . Consequently, when a single blood glucose meter 10 a is used for taking blood glucose measurements of a plurality of patients, the measured blood glucose levels can be stored distinctively for individual patients.
  • the blood glucose meter 10 a After the patient identification data, measuring person identification data, and test piece identification data have been read in this manner, the blood glucose meter 10 a enters into a measurement mode.
  • the cap 39 is removed, and the test piece 12 is pushed into the distal end mounting portion 30 together with the individual package casing, until a click is felt. Thereafter, only the casing is removed. By this operation, the test piece 12 becomes mounted on the distal end mounting portion 30 .
  • the measuring portion 32 displays the word “OK” on the monitor 34 , and then automatically enters into the blood glucose measurement mode. Further, puncturing is carried out by a predetermined puncturing device in order to provide a blood drop 60 on a fingertip (in the following description, on the forefinger of the left hand).
  • the patient then carries out a spotting action by bringing the spotted portion 22 of the test piece 12 into contact with the blood drop 60 , while the patient grasps the blood glucose meter 10 a with the right hand. At this time, the left and right wrists or neighboring portions thereof are placed in a stabilized state on the table T.
  • the blood drop 60 can be prevented from coming into contact and sticking to a peripheral portion of the spotted portion 22 , a side face of the projection 18 , or a portion of the flange 16 .
  • the blood glucose meter 10 a may be moved closer in order to carry out spotting in a state in which one finger 68 (for example, the forefinger) on which the blood drop 60 is formed remains placed on the table T.
  • the distance H 1 of the spotted portion 22 from the table T is 13 mm.
  • the height of the blood drop 60 is approximately within a range from 3 mm to 20 mm, and ordinarily, is approximately within a range from 5 mm to 14 mm.
  • the direction and height of the finger 68 can be adjusted within such a range, it is easy to adjust the height with respect to the spotted portion 22 , and it is easy to bring the spotted portion 22 into contact with the blood drop 60 .
  • the finger 68 and the blood glucose meter 10 a are placed directly on the table T, the finger 68 and the blood glucose meter 10 a are kept highly stable, respectively, so that the spotting operation can be carried out reliably.
  • another finger 69 (for example, the middle finger), which is adjacent to the finger 68 on which the blood drop 60 is formed, may be placed on the table T while the finger 68 is placed atop the finger 69 , as seen in FIG. 13 . If the two fingers 68 and 69 are placed on the table T in this manner, then the height of the blood drop 60 on the upper side finger 68 varies depending on the manner in which the fingers are crossed, the manner of placement of the fingers, and so forth. However, the height as described above generally lies within a range from 5 mm to 30 mm, and ordinarily, lies within a range approximately from 9 mm to 20 mm.
  • the height is not 13 mm initially, since the direction and the height of the finger 68 can be adjusted within such a range, it is easy to adjust the height with respect to the spotted portion 22 , and it is easy to bring the spotted portion 22 into contact with the blood drop 60 .
  • the blood glucose meter 10 a is placed directly on the table T, the blood glucose meter 10 a is kept highly stable.
  • the finger 68 which is placed on the finger 69 , also is kept stable in a suitable manner, whereby a reliable spotting operation can be carried out.
  • the finger for example, the forefinger, the middle finger, and the ring finger
  • the finger which is positioned on top of the other fingers
  • the spotting operation may be carried out in midair, without using the table T.
  • the test paper 20 exhibits a color reaction with a reagent in response to the blood glucose level.
  • the measuring portion 32 observes the color reaction of the test paper 20 .
  • the control section 33 performs a predetermined calculation in order to calculate the blood glucose level, and the blood glucose level is displayed on the monitor 34 .
  • a notification may be issued by a buzzer in order to indicate that the measurement operation has ended.
  • the ejector lever 36 is operated in order to remove the test piece 12 together with the cover. Then, the power supply is turned off, and the cap 39 is placed on the distal end mounting portion 30 .
  • FIGS. 10 to 13 The operation method illustrated in FIGS. 10 to 13 is applied to a case in which the blood glucose meter 10 a is intended for personal use, in which a patient carries out blood glucose measurement.
  • a health care worker 62 may carry out operations using the blood glucose meter 10 a , as shown in FIGS. 14 and 15 .
  • the main portion 44 continues to lie substantially horizontal. Consequently, the health care worker 62 can grasp the blood glucose meter 10 a in a comfortable posture with the elbows allowed to suspend downwardly.
  • FIG. 14 illustrates a case in which a health care worker 62 carries out a spotting operation for a patient 64 in a reclining state on a bed 63 .
  • the process illustrated in FIG. 8 , the process illustrated in FIG. 9 , and the blood glucose measuring process subsequent thereto may be carried out in any order.
  • the reading processes of individual identification data one or more of such processes may be carried out.
  • a configuration in which reading of data is carried out while blood glucose measurement is carried out simultaneously therewith may also be adopted.
  • the test piece 12 is provided on the distal end mounting portion 30 , and the barcode reader 48 is provided on the opposite rear end face. Therefore, even if the data reading button 40 is depressed inadvertently, a laser beam for scanning is not emitted in a direction toward the patient, and the patient does not experience discomfort. Also, upon reading of patient identification data, although the laser beam may occasionally be oriented in a direction toward the patient, at this time, the user carries out the operation while attention is focused on laser reading, and further, the laser beam merely impinges upon the wrist band 64 a and is not directed toward the face of the patient.
  • the barcode reader 48 and the test piece 12 are sufficiently spaced away from each other, and the measurement directions thereof are opposite to each other. Therefore, when reading by the barcode reader 48 is carried out, a situation in which the test piece 12 comes into contact against some other substance does not occur. In other words, before the blood glucose level is measured, the spotted portion 22 of the test piece 12 does not become soiled or broken, so that correct measurement can be carried out. After a blood glucose level measurement has been performed, although blood sticks to the spotted portion 22 , a situation in which the blood sticks to and becomes soiled due to some other substance does not occur.
  • the monitor 34 is provided on the rear side with respect to the data reading button 40 , and the intermediate portion 46 and the distal end mounting portion 30 , which are provided on the distal end side with respect thereto, are suitably thin and light and in good balance.
  • the intermediate portion 46 or the curved face portion 50 is grasped, then the test piece 12 , which is positioned closely thereto, can be stabilized (refer to FIG. 7 ).
  • the barcode reader 48 as an optical data reading means, simple and convenient reading of data can be achieved in a contactless manner.
  • the optical data reading means is oriented suitably, and can carry out reliable reading of data without the possibility of interference, as in wireless communications.
  • the curved face portion 50 Since the curved face portion 50 , the lower face of which is concave, is provided at a location of connection between the main portion 44 and the intermediate portion 46 , a finger can be placed thereon in order to stabilize the blood glucose meter 10 a , so that optical reading by the barcode reader 48 can be carried out stably.
  • Data read by the barcode reader 48 may be transferred to a predetermined data management computer through a predetermined communication port, a memory card, or the like.
  • An optical data transmission means for example, IrDA (Infrared Data Association)
  • IrDA Infrared Data Association
  • the blood glucose meter 10 a is shaped such that, when the blood glucose meter 10 a is placed on a horizontal table T, the center axial line C of the test piece 12 is directed obliquely downward toward the distal end side.
  • the blood glucose meter 10 a is shaped such that the center axial line C is directed obliquely downward toward the distal end side, with reference to a line of extension L of the display face of the monitor 34 ). Consequently, it is easy to orient the spotted portion 22 of the test piece in a direction toward the blood drop, and the spotted portion 22 of the test piece 12 can be brought into contact with the blood drop 60 obtained by puncture easily and reliably, so that measurement errors can be suppressed.
  • the angle 81 defined between the line of extension L and the center axial line C is set to 10° or greater, and more preferably, to 15° or greater.
  • the angle ⁇ 1 is set to a large value, then since the intermediate portion 46 may be directed downwardly by an excessive amount, there is a possibility, when the blood glucose meter 10 a is grasped and the blood glucose meter 10 a is positioned, for visibility of the spotted portion 22 to become worse.
  • the feeling of stability may become impaired, or the spotted portion 22 may not be oriented properly in a direction toward the blood drop 60 , or when the blood glucose meter 10 a is placed in position, the test piece 12 may come into contact with the table T.
  • the angle ⁇ 1 is set to 40° or less, and more preferably, to 30° or less.
  • the angle ⁇ 1 may be set within a range of 10° to 40°, and more preferably, within a range of 15° to 30°.
  • blood glucose meters 10 b , 10 c and 10 d shall be described. Portions of the blood glucose meters 10 b to 10 d , which are the same as those of the blood glucose meter 10 a , are denoted by like reference characters and detailed descriptions of such features shall be omitted.
  • the distal end mounting portion 30 of the blood glucose meter 10 a is replaced by a distal end mounting portion 72 on which a test piece 70 can be mounted.
  • the test piece 70 is in the form of a thin narrow plate having a blood introduction path 74 provided on a center axial line C thereof.
  • a conventional article can be used as the test piece 70 .
  • the measuring portion 32 measures the blood glucose level of sampled blood based on a current value, which is calculated not by an optical means but by an electro-chemical sensor.
  • the center axial line C of the test piece 70 is directed obliquely downward toward the distal end side, and the angle ⁇ 1 defined between the line of extension L and the center axial line C is set to 27°.
  • the blood glucose meter 10 c according to the second modification is configured for personal use, and includes a smaller number of buttons that make up the operation button group 38 .
  • the blood glucose meter 10 c according to the second modification does not include a data reading button 40 (auxiliary function button), and is smaller in size in comparison with the blood glucose meter 10 a .
  • a monitor 76 for displaying blood glucose levels is smaller than the monitor 34 described above.
  • the angle ⁇ 1 defined between the line of extension L and the center axial line C is set at 18°
  • the angle ⁇ 2 is set at 5°
  • H 1 is set at 10 mm
  • H 2 is set at 7 mm.
  • the blood glucose meter 10 d has a small and thin profile, which facilitates carrying thereof, and the blood glucose meter 10 d does not include a portion corresponding to the intermediate portion 46 described above, but rather includes a distal end mounting portion 30 , which is provided at a distal end portion end face 78 thereof.
  • the distal end portion end face 78 has a shape, which is inclined obliquely as viewed in side elevation (the side elevational view is omitted), and the center axial line C of the test piece 12 is directed obliquely downward toward the distal end side, with reference to the line of extension L of the display face of the monitor 80 .
  • the center axial line C of the test piece 12 (or the test piece 70 ) is directed obliquely downward toward the distal end side with reference to the line of extension L, similar to the blood glucose meter 10 a described above. Accordingly, in both blood glucose meters for hospital use as well as for personal use, it is easy to direct the spotted portion 22 of the test piece 12 (or the test piece 70 ) toward the blood drop 60 , and the spotted portion 22 can be brought into contact readily and reliably with the blood drop 60 obtained by puncture. Consequently, errors in measurement can be suppressed.
  • the blood glucose meters 10 a to 10 d measure blood glucose levels as a property of a sample
  • the present invention is not limited to this example, but can also be applied as an apparatus (blood component measuring apparatus) for measuring hormone levels, cholesterol concentrations, or the like.
  • the barcode reader 48 in the blood glucose meters 10 a and 10 b may comprise another type of optical data reading means, which may be, for example, any of a manual scan type, a CCD scan type, a laser scan type, an image sensing type, or the like.
  • a scan type apparatus made up of a CCD camera
  • reading of a two-dimensional code is possible, whereby the amount of information that can be read increases.
  • predetermined prescription information or the like may be read and verified together with a measured blood glucose level in order to determine an insulin dose.
  • the type of data to be read by the barcode reader 48 is not limited to the aforementioned example.
  • the blood component measuring apparatus according to the present invention is not limited to the embodiment described above, but naturally various other configurations could be adopted without departing from the subject matter of the present invention.

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US20110223078A1 (en) 2011-09-15
CN102216782A (zh) 2011-10-12
WO2010058815A1 (fr) 2010-05-27
EP2352031A1 (fr) 2011-08-03
BRPI0921997A2 (pt) 2016-01-05
CN102216782B (zh) 2014-07-09
BRPI0921997B8 (pt) 2021-07-27

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